Neurology Board Exam

September 21, 2020. The culmination of 4 years of education into one exam consisting of 400 questions to be finished in 7 hours.

To be honest, it was difficult to study for this exam. There is a LOT of information in Neurology, and most of them are a “need to memorize” kind of knowledge instead of “need to process” kind (which I prefer).

I think the most difficult parts for me to study are the clinical pictures of Neuromuscular and Child Neurology. It is so easy to get lost in patients who are all developmentally delayed, or has hypotonia, or has proximal muscle weakness, or has feeding difficulties. Then you have to remember the enzyme missing, or the gene mutated, or what chromosome is the gene located. Then you have to remember the mode of inheritance. Then you have to remember the diagnostic process, and of course, the treatment. By the time you do the questions, all the details of all the diseases are mixed up in your head like the houses and animals that got caught inside a tornado.

Anyway, overall, I think it was a fair exam. I got out feeling great, unlike RITE exams wherein I feel stupid afterwards. LOL

Everything is up to God now. He knows I worked really hard for this. 😁

First Week of Stroke Fellowship

I can honestly say that I am in the right place. We had 19 patients in our service last Monday and even though I was dead-tired, I enjoyed it a lot. I got woken up by the residents a few times but I did not even get cranky because I was genuinely interested in the cases they presented me.

August will be the start of the actual calls, wherein fellows will be the first call for everything. Excited and terrified at the same time. Good thing that Upstate residents are great with stroke care.

Unfortunately, just when I decided to ramp up my blogging again (because I just graduated from residency), I realize that I should be studying for the General Neurology boards.

I will try and post fellowship updates as a “study break”.

God bless!

Officially Brain MD

No longer a “wannabe”

Finally! After 4 years of hard work, I am officially a neurologist. The nervous system has fascinated me since early medical school and I am greatly honored to be taking care of its health.

I would just like to thank my family for supporting me in my journey here in the US. When I told them that I wanted to take the USMLE, leave the Philippines and go to the US for training, I never heard any words of doubt from them. The exams required a lot of money, but my parents never complained and all they showed was true love. They were encouraging all the way which motivated me to get good scores.

I would like to thank my wife’s family, both in the Philippines and in the US. My supposed “family” here in the US abandoned me, and my wife’s family took me in. They fed me and gave me shelter in a country that is difficult (and expensive) to be an immigrant in. They embraced me as one of their own even if at that time, I was not yet married to my wife. I will forever be indebted to them.

My resident batchmates. You guys are crazy, but a lot of fun. The 4 years we endured together will be unforgettable. A lot of memories and a lot of jokes were created, I will miss you all terribly.

The Upstate Neurology faculty. Their passion for teaching and sharing their knowledge is what made me the neurologist I am today.

To all the people that helped me along the way. To those who gave me shelter, to those who gave me rides, to those who gave me advice. You are all God’s little gifts to me in this journey.

Of course, my wife, who was beside me throughout this journey. From medical school, to board reviews, to USMLE reviews, and through residency. We stood strong against all the challenges and I hope and pray that we continue to stand strong against all future challenges.

Last but not the least, thank you God, for all the blessing you have given us. Everything is according to Your will and I will continue to serve Your people and do my work as an offering to You.

In the next few days, I will be entering Vascular Neurology aka Stroke fellowship. I will be focusing more on the brain and its blood vessels. But first, BOARD EXAMS!

“The Answer to Vice is Virtue”

#Rapeculture is once again the topic of many of my Facebook friends. For some reason, some of them cannot fathom more than 1 idea at a time. It is always “instead of teaching women how to dress, teach men not to rape”. While I agree that victim blaming is wrong, I think there is wisdom in dressing decently. So why not both?

This “teach men not to rape” is such a weird notion though. I never recalled my father telling me “son, don’t rape people”. Instead, he reminded me to always respect women and be a gentleman.

Unfortunately, being a “gentleman” would assume differences in sex roles. We assume that men should protect women. However, in a society that continuously tries to blur sex differences, this task becomes increasingly challenging.

Maybe we should bring back the idea that men should protect women. Maybe we should bring back the idea that sex is not just a transaction between two people, but rather something deeper, more emotional, and should only be done with your spouse.

Maybe then rape would no longer be a thing.

Bye Sedan, Hello SUV

After 5 years of service, our 2014 Mazda 6 finally started showing some problems. For some reason, the heater block failed, and we have to spend around 1800 USD to fix it. Of course, being in upstate New York, the heater block is necessary. My wife did not want to spend any more on the car especially if we know we are going to replace it in the next 1-2 years.

So we decided to trade it in and got a 2019 Mazda CX-9 instead.

So yeah, we jumped on the SUV bandwagon and can I just say, this vehicle is awesome. Luxury feels without the luxury price.

Go check out Marivic Flaherty in Romano Mazda in Syracuse. A fellow Filipino who helps us with our car needs.

Future Plans

Been a long time since I posted. I actually forgot that I had a blog. A few days ago, a colleague of mine (who recently passed the PLE, congratulations!) messaged me that he has been reading my blog all along. I rediscovered the purpose of this blog, so here I am, writing again.

I am currently in my PGY-3 (R2) year of Neurology. I am in the process of applying for Vascular Neurology. I really enjoy stroke, the neuroanatomy of it, the acuity and the rush of a stroke code, and the ability to see your patients improve (well, some of them) from a highly morbid condition.

After Vascular Neurology, I might take up Interventional Neurology. Unfortunately, my visa status limits my ability (and my chances, which is already low to begin with) in finding a good training program.

I might try and find a job first, get a permanent residency, and then enter into fellowship again (groan). I discussed this with my mentor and he is very supportive of my plans. He also intends to tailor my fellowship program so that I maximize my diagnostic angiogram skills. This (along with the fact that my wife got a job in Binghamton, yey) is the reason I will probably stay in Syracuse.

Pray for us!

 

Fun Case #1

23/M with a past medical history of illegal substance abuse who came in with right-sided weakness and aphasia. Exam shows global aphasia and right hemiplegia.

 

Diagnosis?

Idle Blog

Hello everyone!

I’m terribly sorry that I haven’t updated this one in a while. Residency takes a lot of my time and whenever I do have a free time, I tend to spend it with my wife or studying or playing (all work and no play makes Jack a dull boy). Anyway, I’m currently in my second year of Neurology residency. Internal Medicine was fun but I won’t miss it. Time to focus on the brain!

The process of doing USMLE is still pretty much the same. I think the only thing that has become a complication is that the Philippine Department of Health is now limiting the release of Statement of Needs. I will be posting on the procedure soon so keep following!

 

How to Apply for the DS-2019

Here are the steps to get the DS-2019 from ECFMG in order to process the J1 visa in the Philippines:

1. Upon getting matched, the GME coordinator of your program should open an application for a DS-2019 in OASIS on the ECFMG website. You will then receive an email to complete/confirm the application on OASIS.
2. Log into OASIS and complete the application. You have to pay $285.00 for the application to be processed.
3. You then have to upload the following documents:
   • Contract/Letter of Offer
     • Should be uploaded by the GME coordinator himself/herself, or by you if sent to you when you matched
   • Medical School Diploma
   • Passport photo
   • Passport Biographic Page
   • Updated Curriculum Vitae
   • Statement of Educational Objectives
     • Letter outlining your plans
   • Ministry of Health Letter/Need To Train Letter
4. Upon uploading all documents, ECFMG will email you that your DS-2019 will be released to your program (it is stated that it takes 4-6 weeks for the documents to be processed but for my case, it only took a week)
5. The program will then mail you the DS-2019 ^_^

 

For the Need To Train Letter, as a Filipino physician, you need to do the following:

1. The Need To Train Letter/Certificate (NTC) is obtained from the DOH, but before going there, make the following documents ready so that you don’t have to go there more than twice:
   1. 5 copies of NTC form (download from the website here) with 5 2×2 original photos (not scanned or printed on the form)
   2. 5 copies of your residency contract OR 5 copies of a letter promising to send the contract once you’re in the US
   3. 5 copies of PRC license (authenticated)
   4. 5 copies of PRC Certificate of Registration (authenticated)
   5. 5 copies of No Pending Case from PRC
   6. 5 Statement of Educational Objectives (US plans)
   7. 5 Career Plans After Exchange Visitor Program (Philippine plans)
2. Go to PRC, bring your PRC license and your PRC Certificate of Registration
3. Go to the Information Center, ask for a Action Sheet for Authentication (or you can download it here)
4. Have your license and CoR photocopied (you need 5 copies of each) inside PRC
5. Go to the 2nd floor of the main building, go to the Legal office and ask for a Action Sheet for No Pending Case
6. Submit the duly accomplished Action Sheet for No Pending Case in Window 4/5 (first floor, left side windows)
7. Go to Window M/N/O, where they issue stamps, have the photocopies of your license and CoR stamped and ask for additional 5 stamps for your No Pending Case certificate
8. Pay the appropriate dues in the cashier, pay an additional rush fee if you want to get your authenticated copies on the same day (takes about a week if not rushed)
9. Submit the Action Sheet for No Pending Case and the 5 stamps in the Legal Office, takes about 15 minutes for them to produce the No Pending Case certificates
10. Submit the Action Sheet for Authentication and the stamped photocopies downstairs in the Window 16/18 (first floor, right side windows)
11. Clerk will stamp the date and time of your return to get your authenticated copies
12. Go to DOH, submit everything. If the signatories are there, you’ll get the NTC the same day. If not, you have to go back the following day. Before handing you the NTC, you will have a 10 minute seminar regarding the Exchange Visitor Program

 

There you go! If you have questions, feel free to comment below! God bless! ^_^

 

 

USMLE Study Guide

So this is my personal study guide for the USMLE. Follow at your own risk. ^_^

Step 1 – 232
First Aid USMLE Step 1 2013 x 2 readings
First Aid USMLE Step 1 2014 x 1 reading
UWorld Step 1 x 30 days

Step 2 CK – 244
First Aid USMLE Step 2 CK 8th Edition x 2 readings
UWorld Step 2 CK x 30 days

Step 2 CS – Pass
First Aid USMLE Step 2 CS 5th Edition x 5 readings
Neeraj Notes x 2 readings

Step 3 – 212
Master the Boards Step 3 3rd Edition x 1 reading
UWorld Step 3 x 60 days

God bless! ^_^